Digital Health in the Era of Reform

Transcription

1 Health Care Financial Management Association (HFMA) & Health Information Management Systems Society (HIMSS) Joint Symposium Digital Health in the Era of Reform Shaun Rangappa, MD, MSHA, Director, Healthcare & Life Sciences Deloitte Consulting LLP September 26, 2014 Agenda Health care technology trends and the evolution of the digital health market Key considerations for the health care industry, including implementation and adoption issues facing providers and organizations as they engage with mobile health technologies Emerging opportunities for new mobile health apps, content, products, and services.

2 Health care technology trends Tech trends 2014: Inspiring disruption Disruptors CIO as venture capitalist Enablers Technical debt reversal Cognitive analytics Social activation Industrialized crowdsourcing Cloud orchestration Digital engagement In-memory revolution Wearables Real-time DevOps Source: Deloitte Tech Trends 2014

3 Trend: Cognitive analytics Artificial intelligence and machine learning have potential to improve quality of patient outcomes Provider treatment options Real-time disease patterns Predictive analytics Forecast consumer attitudes & behaviors Machine learning Natural language processing Advancements in enabling infrastructure Changing the world of health care As part of an integrated ecosystem, a health plan used cognitive analytics to provide patient treatment recommendations Trend: Industrialized crowdsourcing Tapping the power of the crowd in a structured social platform to solve health care problems Simple, task-oriented Language translation Data entry Photo tagging Complex, experience-based Specialized skill set Creative problemsolving. Open-ended, idea generating Challenges oriented around invention Product ideation Funding, consumption, and contribution Sponsorship from the masses Knowledge sharing Civic crowdsourcing The City of Boston uses the Citizens Connect mobile app for Bostonians to report problems ranging from broken streetlights to missed trash pickups

4 Trend: Digital engagement Creating a consistent and contextual way of personalizing, delivering, and monetizing experiences Personalized based on consumer navigation Quantified self movement Customer profile and past purchases to market relevant products Inspiring brand loyalty Pharmaceutical companies are creating companion apps to support patients with their medications Trend: Wearables A new class of mobile devices allows more natural ways to interact with events and services Design principles of wearables Intention Intelligence Enhancement Network Interaction Influence Content Communication The doctor is in (your stomach) Medicine usage and health is tracked through a system that includes both a body-worn patch and a small ingestible sensor

5 Trend: Social activation Moving from sentiment measuring to changing customer s perceptions 1. Focus: Map the Audience 2. Insight: Identify influences 3. Perception: Use brand analysis to identify targeted areas 4. Audience: Distribute content through advocates, enable audience contribution 5. Campaigns: Inject new energy Community outreach Parallels cultivated a passionate community of customers through its influencer and advocate programs What are key considerations for the health care industry?

6 How is the shifting health care landscape providing a platform for disruptive technologies? Shift from volume to value Focus on consumerism Horizontal and vertical convergence Increase access to care and quality Privacy and security of emerging technologies Potential for technology hacking and infection with malware and viruses The HIPAA Privacy Rule defines WHAT health care information needs to be protected Encryption is the required standard for secure data transmission

7 Privacy and security concerns Skepticism about the accuracy of health technology Gap in what some users say they want and the health care industry s current capabilities What steps can the health industry use to adopt these technology trends? Explore ideas from others Look outside your company and industry Understand the consumer Focus on customer service experience Know which problem you are trying to solve Stay grounded in the business so what Focus on gaps in current capabilities Determine how these technologies can provide value

8 Questions remaining around health care technology trends How can I integrate these disruptive technologies into my existing portfolio? What governance structures need to be in place to manage this new technology?? How can my organization create a culture for disruptive technologies? How can I experiment with these new technologies? Exponential growth is expected Device sales 25% growth 172 million in million in 2016 Mobile data usage 514% growth $35 billion in 2008 $180 billion in Copyright 2013 Deloitte Development LLC. All rights reserved.

9 Value of mhealth Increased access to care Value-based care Quality improvement Decreased costs Engaged consumers 16 Copyright 2013 Deloitte Development LLC. All rights reserved. Downloadable health apps for smart devices are a rapidly growing component of mhealth 17 Copyright 2013 Deloitte Development LLC. All rights reserved.

10 mhealth it s in the hands of users Leveraging the power and reach of mobile communications to enable health services provision, mobile offers great versatility and utility for health care Social health networks for information, motivation & support Communication with health providers Self-directed health care Track/record bio-metric data M2M remote monitoring Look up health information Apps to maintain or improve health status & wellbeing Diagnostics & decision support Big data smart dashboards Track/record bio-metric data Imaging & monitoring tools at the bedside Data integrity & error reduction through centralized digital records Digitalized information for exchange between providers M2M remote monitoring Billing Scheduling Administrative simplification Claims processing Purchasing Asset management Clinical trials enrollment Health care CONSUMERS Fitness, healthy living & wellbeing Home monitoring Remote monitoring Health care PROFESSIONALS Physician connectivity Clinician driven bedside tools Diagnostics & decision support Health care INDUSTRY Health facilities Life sciences companies Health plans 18 Copyright 2013 Deloitte Development LLC. All rights reserved. Challenges Some key questions remain unanswered: How do mobile devices used by clinicians interface with the Meaningful Use program? How will the mhealth industry respond to its maturing role as part of the medical device industry? Will the health care industry be able to successfully monetize mhealth? How will an industry plagued by a slow rate of behavior change adapt amid the fast-paced shift being witnessed elsewhere? After guidance from FDA on medical app regulation, how will the mhealth industry navigate the remaining uncertain areas? 19 Copyright 2013 Deloitte Development LLC. All rights reserved.

11 Opportunities Opportunities for developing new mhealth apps, content, products, and services are emerging daily Shift toward a patient-centered and value-based delivery model Transition to a more diverse, integrated, and seamless system of care no longer dominated by episodic acute care treated at a brickand-mortar hospital is evident New fields of opportunity emerge everyday: personalized health care; population health; diagnostics; utilization management; management of infectious diseases and global epidemics 20 Copyright 2013 Deloitte Development LLC. All rights reserved. Our view: four dimensions of mhealth Four critical quadrants must to align properly in order for mhealth to become a reality in various markets Infrastructure National investment in and from telecommunications Emerging and developing markets Health care system infrastructure: bricks and mortar or mobile-grown Mobile penetration Policy Landscape Regulatory burden and innovation factors in telecom, health care, government Privacy and security compliance Taxation via tariffs Payment incentives or disincentives Demographics Economic factors such as median income of the population, strong middle class Rural or urban population centricity Disease Dynamics Health disparities Communicable disease vs. noncommunicable disease burden 21 Copyright 2013 Deloitte Development LLC. All rights reserved.

12 A look at the digital health landscape Evolution of digital health The digital health market has continued to mature and grow rapidly Area Analytics and big data $119M $53M $161M Digital medical devices $2M $59M $146M Digital therapies $2M $23M $63M EHR and clinical workflow $71M $111M $245M Hospital administration $57M $69M $93M Population health management $20M $46M $126M Telemedicine $21M $36M $64M Wearables/biosensing $25M $71M $136M Total (including areas not indicated on this chart, ) $899M $1.4B $1.9B $2.3B midway through Source: 1 Rock Health Digital Funding Report.. 2 Rock Health. Digital Health Funding: Midyear Review, 2014.

13 Digital health funding and projected growth Projected mhealth market growth: $5.1 billion in 2013 to $41.8 billion in YTD digital health funding 2 $211M Payer administration $206M Digital medical devices $196M Analytics and big data $193M Health care consumer engagement $162M Population health management $150M Personalized medicine Sources: 1 Lux Research, mhealth Showdown: Consumer and Clinical Devices Battle for Market Dominance; 2 Rock Health. Digital Health Funding: Midyear Review, The move to mobile Many industries have been using mobile technologies to complement their brickand-mortar sites for years

14 Potential growth opportunities in telehealth and telemedicine Here to stay >50% of U.S. hospitals use at least one telemedicine service. Approximately 200 telemedicine networks have been established nationwide. Decreasing tech costs Videoconferencing and high-definition image-sharing are becoming more interoperable while wireless broadband is becoming more accessible and affordable. Evolving health policy 46 states offer some form of Medicaid payment for 20 telemedicine services. CMS recently proposed expanding telehealth reimbursement in Medicare to cover new services. Addressing the talent shortage The federal government has predicted a health care provider shortage of approximately 24,000 physicians and nearly one million nurses by Sources: 1 The key to making telemedicine work. Health Management Technology, April 2013; 2 National Telehealth Policy Resource Center. State Telehealth Laws and Reimbursement Policies: A Comprehensive Scan of the 50 States and the District of Columbia. February 2014; 3 Health Capital Topics. Volume 4, Issue 4, April Beyond the smartphone: the rise of wearables Biosensing wearables Activity trackers Smart watches Smart clothing Patches and tattoos Ingestibles and smart implants 90 million wearable computing devices are predicted to ship in 2014, approximately 74 million of which will be biosensing. Source: Rock Health. The Future of Biosensing Wearables, 2014.

15 Implementation and adoption Consumers are comfortable with digital sharing of personal information Digital information sharing Health care consumers Health care professionals 62% of consumers are comfortable addressing a health concern through an or text with their health care provider 62% of consumers are comfortable using a video, computer program, or mobile device app to learn more about or choose between different treatment options for a particular condition 52% of consumers are comfortable consulting with their health care provider through a video connection Source: Deloitte Center for Health Solutions, Survey of U.S. Health Care Consumers, 2013

16 Digital health offers versatility and utility for health care Health care consumers Health care professionals Health care industry Current state Fitness, healthy living and wellbeing Home monitoring Remote monitoring Resource for health information Physician connectivity Clinician-driven bedside tools Diagnostics and decision support Billing, scheduling, claims processing Asset management, purchasing Clinical trials enrollment Future state Social health networks for information, motivation, and support Self-directed/self-diagnostics health care Personal sensor data exchange with physician and personalized therapeutics Big data-smart dashboards Data integrity and error reduction via centralized digital records Digitized information for exchange between providers Population health management Enterprise Billing mobile = mobile first/mobile Purchasing only Retail initiatives and web marketing Scheduling Content analytics and customized/channel optimization Administrative Enterprise simplification resource productivity tools Claims processing Asset management Clinical trials enrollment Drivers of digital health Value-based care Increased access to care Cost savings Quality improvement Consumer demand

17 Four dimensions of effective mhealth Obstacles and opportunities

18 Driving consumer and industry adoption Convenience Rationale Consumer adoption Interoperability Privacy Validity Reliability Industry adoption Motivation Evidence Assessing organizational readiness for digital health Define goals Understand capabilities & challenges Build stakeholder support Define success Understand demographics

19 Opportunities for digital health Patients Life sciences Employers Health plans Health care providers Mobile devices: no longer simply a piece of hardware used to make a phone call Ever-present Moved beyond facilitating voice transmissions Smart enabler of interactivity and exchange of information, text, data, images Now offer array of health apps Source: Deloitte Center for Health Solutions, mhealth in an mworld: How Mobile technology is transforming health care, 2012 Copyright 2013 Deloitte Development LLC. All rights reserved.

20 Physician practices are beginning to adopt patient support tools Use of patient support tools Practice has an EHR meeting MU Stage 1 requirements (N=404; 66%) Practice does not have an EHR meeting MU Stage 1 requirements (N=161; 26%) Communicate with consumers using /texts Online consumer visit scheduling/test result access Direct consumers to online health care content 37% 27% 31% 10% 30% 17% Online consumer prescription refills 26% 5% Mobile consumer visit scheduling, test results and medical records access, or payment-making Telemedicine used for follow-up or diagnostic visits with consumers Online prices for routine transactions for consumers 19% 2% 18% 10% 5% 1% Source: Deloitte Center for Health Solutions, Physician adoption of health information technology: Implications for medical practice leaders and business partners, 2013 Copyright 2013 Deloitte Development LLC. All rights reserved. Mobile offers versatility and utility for health care Source: Deloitte Center for Health Solutions, mhealth in an mworld: How Mobile technology is transforming health care, 2012 Copyright 2013 Deloitte Development LLC. All rights reserved.

21 mhealth in action Copyright 2013 Deloitte Development LLC. All rights reserved. Technology Capabilities to Drive Business Value 1 Connectivity, Security and Interoperability Practitioner 2 3 Practitioner Insurer Data Integration and Management Data Analytics and Content Insurer Acute IP Natural Language Processing Acute IP Clinic 4 Clinic Ancillary Core Applications and Workflow/Automation Physician/Patient Engagement Ancillary Supplier 5 Supplier Patient Patient 1. Connectivity, Security and Interoperability: connects to all the data producers, provides access to data consumers, and validates access rights. 2. Data Integration and Management: retrieve data from the data producers, in both structured and unstructured form, and transform it to align with core application data requirements as well as end user analytical needs. 3. Data Analytics and Content: using self-actualizing trends and business solution specific heuristics analyzes transactional data and creates enriched information. Data delivery occurs via screen-reports and services/api. 4. Core Applications and Workflow / Automation: Orchestrates the execution of activities the constitute the care continuum, gathering contextual information from both the transactional systems as well as the data-warehouse. 5. Physician/Patient Engagement: Key interfaces for both patients and physicians to facilitate their interactions with the VBC system, leveraging workflow and analytics to enhance engagement and satisfaction for both these stakeholders.

22 CONSUMERS CAREGIVERS PROVIDERS Enhancing care integration DEVICE MANUFACTURERS Devices enable objective tracking and management of a consumers health and well-being. prevention & wellness Fitness Acute Tracking Diagnosis Devices disease mgmt. health coordination Inpatient Chronic Mgmt. Adherence Data Aggregation, Analytics & Exchange Stakeholders Caregivers Consumers Providers Device Manufacturers Health Plans

23 Ecosystem of device data creates a complete patient for actionable, transparent, and enhanced health system management 1 continuous monitoring network Hospital Home COMPLETE Lab / Pharmacy PATIENT VIEW 2 ecosystem of device data Caregivers Specialists PCP About Deloitte Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see for a detailed description of the legal structure of Deloitte Touche Tohmatsu Limited and its member firms. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting. Member of Deloitte Touche Tohmatsu Limited